1. Field of the Invention
The present invention relates to medical imaging of blood vessels, and more particularly concerns the use of magnetic resonance to obtain such imaging.
2. Description of Related Art
Angiography, or the imaging of vascular structures, is very useful in diagnostic and therapeutic medical procedures. In X-ray angiography, a bolus of x-ray opaque liquid is placed into the vessel of interest through an invasive device placed into the vessel. While the bolus is within the vessel, a series of X-ray images is obtained which highlight the X-ray absorbing liquid.
X-ray angiography carries several significant risks to the patient. For example, the x-ray opaque liquid can cause discomfort and adverse reactions within the patient. While conventional X-ray fluoroscopes are designed to minimize X-ray dosage, some procedures can be very long and the accumulated X-ray dose to the subject can become significant. The long term exposure of the attending medical staff is of even greater concern since they participate in these procedures regularly. Consequently, it is desirable to reduce or eliminate the X-ray dose during these procedures.
X-ray angiography, typically produces a single two-dimensional image. Information concerning the depth of an object within the field-of-view is not available to the operator. It is often desirable to obtain this information during diagnostic and therapeutic procedures.
Magnetic resonance (MR) imaging procedures for the imaging of vascular structures have recently become available. MR angiography is performed with a variety of methods, all of which rely on one of two basic phenomena. The first phenomena arises from changes in longitudinal spin magnetization as blood moves from one region of the patient to another. Methods that make use of this phenomenon have become known as "in-flow" or "time-of-flight" methods. A commonly used time-of-flight method is three-dimensional time-of flight angiography. With this method, a region of interest is imaged with a relatively short repetition time, TR, and a relatively strong excitation radio-frequency (RF) pulse. This causes the MR spins within the field-of-view to become saturated and give weak MR response signals. Blood flowing into the field-of-view, however, enters in a fully relaxed state. Consequently, this blood gives a relatively strong MR response signal, until it too becomes saturated. Because of the nature of blood vessel detection with time-of-flight methods, the stationary tissue surrounding the vessel cannot be completely suppressed. In addition, slowly moving blood, and blood that has been in the imaged volume for too long, becomes saturated and is poorly imaged.
A second type of MR angiography is based on the induction of phase shifts in transverse spin magnetization. These phase shifts are directly proportional to velocity and are induced by flow-encoding magnetic field gradient pulses. Phase-sensitive MR angiography methods exploit these phase shifts to create images in which the pixel intensity is a function of blood velocity. While phase-sensitive MR angiography can easily detect slow flow in complicated vessel geometries, it will also detect any moving tissue within the field-of-view. Consequently, phase-sensitive MR angiograms of the heart have artifacts arising from the moving heart muscle and from the moving pools of blood in the heart chambers.
Several methods for the tracking of an interventional device using MR have also been disclosed. These have been described in the U.S. Patent applications previously mentioned in `CROSS REFERENCES TO RELATED APPLICATIONS`. Following an invasive device within a patient using these MR techniques has the advantage that the invasive device location is determined using the same physical relationships used to make the MR image. Consequently, the registration of invasive device position with respect to the image is excellent. These, however, do not specifically image blood vessels, but provide MR images with a superimposed symbol representing the position of an invasive device.
Currently, there is a need for a simple method of obtaining high quality angiograms of a selected vessel without the risks of exposure to ionizing radiation and X-ray opaque contrast injections.